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Biomedical subjects

D McIntosh

Publications and source records attributed to D McIntosh.

At least 19 recordsLinked to original sources
PubMed1996

Mutation of gene of mannose-binding protein associated with chronic hepatitis B viral infection.

BACKGROUND: Persistent with hepatitis B virus (HBV) affects 350 million people worldwide, and 20-40% of infected patients die of cirrhosis and liver cancer. Little is known about the host factors that determine the variable natural history. Studies have focused on the role of acquired rather than innate immunity. We have investigated the prevalence of mutations in the gene for mannose-binding protein (MBP), which have been associated with susceptibility to bacterial and fungal infections. METHODS: Mutations in the MBP gene were sought by sequence-specific oligonucleotide hybridisation, site-directed sequencing in Caucasian and Asian patients with HBV infection, and in HBsAg-negative controls. FINDINGS: A mutation in codon 52 of the MBP gene was present in two (11%) of 19 Caucasian patients with acute hepatitis B and nine (27%) of 33 Caucasian patients with chronic hepatitis B, compared with four (4%) of 98 Caucasian controls (p = 0.0004). By contrast the prevalence of the mutation was similar in Asian patients with chronic hepatitis B and in Asian controls (one [5%] of 20 vs two [2%] of 117). Mutations in codon 54 and codon 57 were found in similar proportions of patients and controls. INTERPRETATION: These findings show in Caucasian, but not Asian, patients an association of the codon 52 mutation of the MBP gene with persistent HBV infection. They suggest an important role for this gene, or a gene in linkage disequilibrium with MBP, in determining outcome after HBV infection in adult but not neonatal life.

Acute Disease↗
PubMed1996

A simplified PCR-based method for the detection of Renibacterium salmoninarum utilizing preparations of rainbow trout (Oncorhynchus mykiss, Walbaum) lymphocytes.

A method for the detection of Renibacterium salmoninarum by PCR is described. A rapid, reliable procedure was developed for the extraction of DNA, which could be applied to infected kidney homogenates and head kidney lymphocyte preparations. The target for DNA amplification was a 376-bp region of the gene encoding the 57-kDa major surface antigen (MSA). The PCR was specific for R. salmoninarum and allowed the detection of 10 to 100 cells of the pathogen. Use of the PCR for the examination of experimentally infected rainbow trout showed it to be as reliable as plate culture methods for the detection of R. salmoninarum in infected kidneys.

Animals↗
PubMed1994

Salvage therapy for recurrent and refractory ovarian cancer with high-dose chemotherapy and autologous bone marrow support: a Gynecologic Oncology Group pilot study.

Nine patients with recurrent or refractory epithelial ovarian carcinoma following previous chemotherapy were treated with high-dose carboplatin (300 mg/m2) and ifosfamide according to a dose escalation schedule (1.50, 1.75, 2.00 g/m2), each given intravenously daily for 5 days with autologous bone marrow support. Eight of the nine patients were evaluable for response. Five achieved complete response (CR), all of whom relapsed at 4, 5, 6, 8, and 23 months following treatment. Two partial responses persisted for 6 months, and one patient with stable disease progressed after 2 months and has since died of disease. The median duration of remission was 6 months. The treatment was well tolerated across the doses of ifosfamide with the exception of one treatment-related death which was due to acute renal failure and central nervous system toxicity from ifosfamide. It appears that the use of high-dose chemotherapy with autologous bone marrow support in the treatment of ovarian cancer produced a high rate of response of short duration in this small group of heavily pretreated women.

Adult↗
PubMed1994

Effect of distance from the polluting focus on relative concentrations of Bacteroides fragilis phages and coliphages in mussels.

Concentrations of fecal bacteria, somatic and F-specific coliphages, and phages infecting Bacteroides fragilis in naturally occurring black mussels (Mytilus edulis) were determined. Mussels were collected over a 7-month period at four sampling sites with different levels of fecal pollution. Concentrations of both fecal bacteria and bacteriophages in mussel meat paralleled the concentration of fecal bacteria in the overlying waters. Mussels bioaccumulated efficiently, although with different efficiencies, all of the microorganisms studied. Ratios comparing the levels of microorganisms in mussels were determined. These ratios changed in mussels collected at the different sites. They suggest that bacteriophages infecting B. fragilis and somatic coliphages have the lowest decay rates among the microorganisms studied, with the exception of Clostridium perfringens. On the contrary, concentrations of F-specific coliphages showed a greater rate of decay than the other bacteriophages at sites more distant from the focus of contamination. Additionally, levels of enteroviruses were studied in a number of samples, and in these samples, the B. fragilis bacteriophages clearly outnumbered the enteroviruses. The results of this study indicate that, under the environmental conditions studied, the fate of phages infecting B. fragilis released into the marine environment resembles that of human viruses more than any other microorganism examined.

Animals↗
PubMed1993

Cathexes and their objects in the thought of Sigmund Freud.

This paper reexamines Freud's theory of "cathexis" (a quantity of motivational intensity invested in an object) in the light of recent developments in philosophy and cognitive psychology. Contrary to what is often thought, the quantitative element is defensible as a purely psychological idea. The notion of a cathexis is closely similar to the philosophical idea of an "intentional" state, which derives from Franz Brentano, Freud's teacher and mentor. Freud initially held the object of a cathexis always to be intrapsychic, a position which is untenable and which he largely abandoned after 1915, when he began (correctly) to take cathected objects generally to be persons or events, not their representations. His idea of a cathexis as "entering into" its object contains a valuable and neglected insight, which undermines the centrality of the distinction between the "outer" and "inner" realms of experience. This distinction should not be confused with the key distinction between "fantasy" and "actuality" with respect to cathectic objects. So-called "inner" (fantasy) objects are generally "inside" the mind in a metaphorical sense only.

Cathexis↗
PubMed1993

Effects of lung hyperinflation and presence of positive end-expiratory pressure on arterial and tissue oxygenation during endotracheal suctioning.

PURPOSE: To explore the effects of endotracheal suctioning on mixed venous oxygen tension and other measures of arterial and tissue oxygenation, to determine if these would be clinically useful outcome measures of endotracheal suctioning. BACKGROUND: Measuring arterial oxygenation only as an outcome of endotracheal suctioning can be misleading in that it may appear adequate in the presence of marked decreases in mixed venous oxygen tension, a good indicator of the adequacy of tissue oxygenation. METHODS: Eighteen instrumented and oleic acid-injured animal models of acute respiratory failure undergoing closed-system endotracheal suctioning were studied according to a 2 x 2 factorial design to measure the effects of oxygen inflations at tidal volume or 135% of tidal volume either in the presence or absence of positive end-expiratory pressure. RESULTS: Using multivariate analysis of variance for repeated measures, protocol by time effects for mixed venous oxygen tension, arterial oxygen saturation, arterial oxygen tension, oxygen delivery and oxygen extraction ratio were statistically significant. Changes in mixed venous oxygen tension and arterial oxygen saturation were parallel. CONCLUSIONS: Continuous measurement of mixed venous oxygen tension allows the calculation of oxygen delivery and oxygen extraction ratio, which provide a better estimation of the effects of endotracheal suctioning on tissue oxygenation than arterial oxygen tension alone.

Acute Disease↗
PubMed1992

Interactions between marine bacteria and dissolved-phase and beached hydrocarbons after the Exxon Valdez oil spill.

Turnover times for toluene in Resurrection Bay after the Exxon Valdez grounding were determined to be decades, longer than expected considering that dissolved hydrocarbons were anticipated to drift with the current and stimulate development of additional hydrocarbon-utilizing capacity among the microflora in that downcurrent location. These turnover times were based on the recovery of 14CO2 from added [14C]toluene that was oxidized. The concentrations of toluene there, 0.1 to 0.2 microgram/liter, were similar to prespill values. Oxidation rates appeared to be enhanced upstream near islands in the wake of the wind-blown slick, and even more within the slick itself. Specific affinities of the water column bacteria for toluene were computed with the help of biomass data, as measured by high-resolution flow cytometry. They were a very low 0.3 to 3 liters/g of cells.h-1, indicating limited capacity to utilize this hydrocarbon. Since current-driven mixing rates exceeded those of oxidation, dissolved spill components such as toluene should enter the world-ocean pool of hydrocarbons rather than biooxidize in place. Some of the floating oil slick washed ashore and permeated a coarse gravel beach. A bacterial biomass of 2 to 14 mg/kg appeared in apparent response to the new carbon and energy source. This biomass was computed from that of the organisms and associated naphthalene oxidation activity washed from the gravel compared with the original suspension. These sediment organisms were very small at approximately 0.06 microns 3 in volume, low in DNA at approximately 5.5 g per cell, and unlike the aquatic bacteria obtained by enrichment culture but quite similar to the oligobacteria in the water column.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗
PubMed1992

Postoperative respiratory function after laparoscopic cholecystectomy.

Open cholecystectomy causes changes in pulmonary function test volumes; such changes can be related to respiratory complications of hypoxemia and atelectasis. Little data is available on lung volume changes after laparoscopic cholecystectomy. We measured preoperative and postoperative vital capacity (VC), functional residual capacity (FRC), arterial PO2, and chest X-ray atelectasis in 31 patients undergoing laparoscopic cholecystectomy and found small but significant decreases (p < 0.01) in VC (13 +/- 19%) and FRC (7 +/- 17%). The PO2 decreased from 89 +/- 11 mm Hg to 82 +/- 14 mm Hg, with only one patient's PO2 less than 60 mm Hg. Three patients demonstrated new segmental lobar collapse on postoperative chest X-ray. The postoperative changes in FRC (R2 = 0.40, p < 0.04) and atelectasis (R2 = 0.46, p < 0.03) could be predicted by multiple regression of risk factors, including obesity, smoking, use of narcotics, age, and symptoms of prior respiratory disease. We conclude that the respiratory changes after laparoscopic surgery are small in comparison to those expected after open cholecystectomy.

Cholecystectomy, Laparoscopic↗
PubMed1991

The flexible boundaried group: format, techniques, and patients' perceptions.

The model of a flexible boundaried group was developed to manage the problem of irregular group attendance of chronic mentally ill patients. The central element in the model enables patients to determine, within limits, the frequency with which they will attend sessions. Review of attendance records and patient interviews from one flexible group suggest that members adhere to their contractual agreement and are accepting of irregular attenders. This finding has been supported by experiences in three additional groups composed of chronically ill individuals. These groups, comprised of regular, core attenders and peripheral members, become cohesive and form a viable therapeutic treatment structure.

Chronic Disease↗
PubMed1991

Atypical characteristics of the salmonid pathogen Aeromonas salmonicida.

Incubation of Aeromonas salmonicida at supra-optimal temperatures, i.e. 30-37 degrees C, resulted in the expression of motility by polar flagella, and changes in sugar fermentation patterns, e.g. loss of acid production from mannitol, loss of the ability to degrade complex molecules (aesculin, DNA, elastin and gelatin), and an increase in antibiotic resistance (notably co-trimoxazole). Motility was enhanced in cultures grown in brain heart infusion broth supplemented with 18% (w/v) Ficoll.

Aeromonas↗
PubMed1991

Effect of different doses of omeprazole on 24-hour oesophageal acid exposure in patients with gastro-oesophageal reflux.

To define the optimum doses of omeprazole appropriate for acute and long-term therapy of patients with gastro-oesophageal reflux disease, 24-h oesophageal pH was measured in 12 patients with symptomatic reflux and an abnormal 24-h oesophageal acid exposure time (greater than 6%) in a randomized, double-blind, four-way crossover study comparing the effects of omeprazole 10, 20, or 40 mg/day and placebo. Total reflux time over 24 hours, number of reflux episodes per hour, and the number of reflux episodes lasting greater than 5 minutes were measured by ambulatory 24-h oesophageal pH monitoring. All doses of omeprazole were superior to placebo in decreasing gastro-oesophageal reflux as measured by each index. With placebo, oesophageal acid exposure was 16.3% of the 24 hours, 10 mg omeprazole/day reduced that to 6.3%, 20 mg/day lowered acid exposure to 0.9%, and 40 mg/day to 0.6%. Thus only the 20 and 40 mg doses reduced acid exposure to within the normal range. Similar results were obtained with the other indices of reflux. These data suggest that a rational dose regimen for reflux oesophagitis is 20 mg/day, a regimen that has proved effective in clinical trials. The present study indicates that 24-hour oesophageal pH monitoring is a practical approach to the determination of drug dosage in patients with gastro-oesophageal reflux.

Adult↗
PubMed1991

Supportive therapy: the other therapy.

Nurses have a long history of caring for clients with chronic mental illness. A primary treatment modality used with these clients is supportive psychotherapy. Often this approach is not well understood, even by those who purport to practice it. While supportive therapy tends not to enjoy the prestige associated with other forms of individual psychotherapy, the author contends that supportive psychotherapy can be an interesting and challenging treatment modality for working with clients with chronic mental illness.

Chronic Disease↗